<div id="tempdrug_purchases">			
		<form class="form-horizontal main-form" role="form">
			
			<fieldset>
				
				<div class="form-group">
					<label for="name" class="col-md-2 col-sm-3 control-label">具体事项</label>
					<div class="col-sm-9 col-md-10">
						<input type="text" class="form-control" id="name" name="name"/>
					</div>
					
				</div>
				<div class="form-group">
					
					<label for="apply_date" class="col-md-2 col-sm-3 control-label">填表日期</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="apply_date" name="apply_date"/>
					</div>
					<label for="bizno" class="col-md-2 col-sm-3 control-label">业务编号</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="bizno" name="bizno"/>
					</div>
				</div>
					
				<div class="form-group">
					
					<label for="apply_deptname" class="col-md-2 col-sm-3 control-label">申请科室</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="apply_deptname" name="apply_deptname"/>
					</div>
					 <label for="apply_name" class="col-md-2 col-sm-3 control-label">申请人员</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="apply_name" name="apply_name"/>
					</div>
				</div>		
				
				<div class="form-group">
					 <label for="patient_id" class="col-md-2 col-sm-3 control-label">住院号</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="patient_id" name="patient_id"/>
					</div>
					
					<label for="surgery_date" class="col-md-2 col-sm-3 control-label">手术日期</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="surgery_date" name="surgery_date"/>
					</div>
				</div>	
				
				<div class="form-group">
					 <label for="patient_name" class="col-md-2 col-sm-3 control-label">患者姓名</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="patient_name" name="patient_name"/>
					</div>
					
					<label for="patient_dept_name" class="col-md-2 col-sm-3 control-label">住院科别</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="patient_dept_name" name="patient_dept_name"/>
					</div>
				</div>		
				
				
				
				
				<div class="form-group">
					<label for="outpatient_cost" class="col-md-2 col-sm-3 control-label">收门诊费</label>
					<div class="col-sm-3 col-md-4" >
						<div class="radio-inline">
						  <label>
						    <input type="radio" name="outpatient_cost" id="outpatient_cost1" value="1" checked>是
						  </label>
						</div>
						<div class="radio-inline">
						  <label>
						    <input type="radio" name="outpatient_cost" id="outpatient_cost2" value="0">否
						  </label>
						</div>
					</div>
					<label for="supply_name" class="col-md-2 col-sm-3 control-label">供货商</label>
					<div class="col-sm-3 col-md-4">
						<input type="text" class="form-control" id="supply_name" name="supply_name"/>
					</div>
				</div>				
				
				
				<div class="form-group">
					<label for="apply_content" class="col-md-2 col-sm-3 control-label">申请理由</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="apply_content" rows="5" name="apply_content"/>
					</div>	
				</div>
				
				<!--内嵌列表 -->
				<div class="form-group">
					<div class="sub-list" id="dg-inner-highvalue"></div>
				</div>		
			
				<div class="form-group">
					<label for="dept_content" class="col-md-2 col-sm-3 control-label">科室意见</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="dept_content" rows="5" name="dept_content"/>
					</div>	
				</div>
				
				<div class="form-group">
					<label for="audit_content" class="col-md-2 col-sm-3 control-label">计费审核</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="audit_content" rows="5" name="audit_content"/>
					</div>	
				</div>
					
				<div class="form-group">
					<label for="biz_content" class="col-md-2 col-sm-3 control-label">设备科意见</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="biz_content" name="biz_content" rows="5"/>
					</div>	
				</div>
				
				<div class="form-group">
					<label for="directLeader_content" class="col-md-2 col-sm-3 control-label">科室主管<br/>院长审核</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="directLeader_content" name="directLeader_content" rows="5"/>
					</div>	
				</div>
				
				<div class="form-group">
					<label for="chargeLeader_content" class="col-md-2 col-sm-3 control-label">业务分管<br/>院长审核</label>
					<div class="col-sm-9 col-md-10">					
						<textarea  class="form-control" id="chargeLeader_content" name="chargeLeader_content" rows="5"/>
					</div>	
				</div>			

				<div class="form-group">
					<label for="archive" class="col-md-2 col-sm-3 control-label">附件</label>
					<div class="col-sm-9 col-md-10">					
						<div class="fileList" id="archive" name="archive"></div>
					</div>	
				</div>					
												
				<input name="id" id="id" type="hidden" />
				<input name="bizid" id="bizid" type="hidden" />
				<input name="flowInstId" id="flowInstId" type="hidden" />
				<input name="flowTaskId" id="flowTaskId" type="hidden" />
				<input name="created" id="created" type="hidden" />
				<input name="creater" id="creater" type="hidden" />


				<input name="apply_id" id="apply_id" type="hidden" />
				<input id="apply_deptid" name="apply_deptid" type="hidden" />
				

			</fieldset>
		</form>
</div>
<script>

requirejs(['oaMain','domReady!'],function(flowedit,doc){
	flowedit.initEdit({initElement:null});
})
</script>

